Confused and Upset

[TessaOKC]

I am a 47 year old mtf transexual just starting the transitioning process. I am seeing a therapist in order to get an HRT letter to begin hormones. After four sessions, the therapist said that I was possibly not transgendered and that what I was more than likely experiencing a fetish. I was crushed. Even though the feeling to transition has been a rollar coaster ride, I know what I am! I am sad that it feels as though I have to "Prove" I am transgendered or transexual.

Even though at times I am comfortable as my male self, overwhelmingly I identify as a female. My female identification is more internalized as I don't feel a need to present as a female just yet. I wanted to begin hormones, loose weight (which I have), grow my hair out (which I'm doing), before I started presenting as female. I feel like because I didn't go to therapy dressed in a flowery dress and heels, I am doubted.

Transitioning is a very personal process that takes many shapes and forms. Just because I don't fit the textbook definition of being mtf transgendered doesn't mean that I am not transgendered or transexual.

Would love to hear other stories and also any input on what others might think of my situation. Thanks so much! Tess

[STACY B]

There is a Ton of things you can do without HRT ,, Maybe hair removal ? Work on your voice ? Find your style ? Makeup ,,Hair ,, an Nails ,, Shave your body,, Female mannerisms ,, Think about your financal future ? Where are you going to work ,,Live ,, HRT is not a save all . An when you get a lot of those other things out of the way you can always find another therapist .

By the way you need to loose weight BEFORE HRT not wait until your on it ,, Most times you Gain ,,Not loose !! Anyway that's why you went to a Therapist for advice ,, Take it . Transition is a LONG ROAD .. Not for the WEAK !!

[TessaOKC]

Thank you Stacy :)

Yes, the weight loss is before the hormones..... My point with the post is, why do we have to prove our transgenderism? The reason for therapy before the hrt letter is to assure we understand what we are doing. I think my therapist is acting like a gate keeper to the access to hormones. This, in my opinion, is not what I was expecting from therapy. I will try to educate her during my next session and if it doesn't work then I will find a new therapist. One of the pitfalls of transitioning I suppose!

[Dianne S]

I would press your therapist as to why she doesn't think you're "truly" transgender. Then consider the response. And if you're not satisfied with it and believe in your heart you are transgender, then find another therapist.

Edit: I replied before seeing your reply above. Looks like we're on the same wavelength! :) Good luck.

[Kaitlyn Michele]

You are gonna have to fight for HRT then.

If this therapist can't get there, find another. But based on your posts you seem pretty smart, focused and reasonable....I bet you can do it with your therapist

Not being there, I can't even begin to guess whether withholding HRT letters is reasonable or not.
I did therapy for a year before I started HRT fwiw... I didn't "Dress" until well into that year and even then I didn't do it all the time...work, life, kids etc...

[LeaP]

First, congratulations on having found a responsible therapist. A therapist, just like a physician, has a professional responsibility to determine the appropriate type of care. Say you were self diagnosed with a medical issue and went to your doctor. Assume you are 100% correct about the diagnosis. Do you think for a second the doctor is going to simply take your word for it? Or will there be an examination? Okay, you were right, now what? Medication? What kind, at what level, and under what conditions? Surgery?

Enter the therapist. In comes a new client. A good gender therapist knows that gender issues and gender identity issues can present for a variety of reasons. They also know that, even in the case of true gender identity issues, that there are a variety of responses to different counseling and therapeutic approaches. It is also true that an outsized percentage of clients who present for gender issues come through the door looking for hormones - and a lot of those are not candidates for them.

So, I'm assuming you consulted this therapist for their professional knowledge and expertise, perhaps you should ride with that awhile. I will say that the fact that this therapist made such a pronouncement after only a few visits is a little disquieting, but that is easily cleared up by asking, as Dianne indicated. On the other hand, it is also a little disquieting that you were so crushed by the statement. Believe me, I understand how such things can hit you in the gut, but perhaps the extremity of the reaction should give you pause to ask yourself whether you are truly ready to start hormones.

You don't have to prove anything and you don't have to show up in a flowery dress. Like Kaitlyn, I was in therapy for quite a while before I started hormones. With very few exceptions, I was coming from work when I went to my appointment, so I was showing up in suit and tie.

You are presenting us with two very different views of your confidence. The contrast is so strongly declaring that you know who you are versus being crushed by the therapist's statement. Try staying with this therapist for at least a while. If you are trans, it will work out.

[Rachel Smith]

I was in therapy for about 1 1/2 years before I started HRT. In that time there was a lot of self discovery. Take your time. This is not something you want to do unless you NEED to. Though I am much happier with myself there was and still is a price to pay for my transition and I had it easier than many.

[Michelle.M]

I am seeing a therapist in order to get an HRT letter to begin hormones.

This is not why one goes to see a therapist. Transition therapy is useful to help you identify the challenges to making a gender transition and to help you develop ways to deal with those challenges.

Perhaps your therapist thought you were letter shopping? In any event, you need to explore why the therapist thinks this is a fetish, and then go from there.

[KellyJameson]

Hi Tess

If you are comfortable talking about it could you share why the therapist thinks it is more likely you are experiencing a fetish.

I hate flowery dresses and the color pink and I made it clear I was not going to do some type of "Dog and Pony Show" with clothes just to "prove" to someone I'm a woman. I dress the way I want to dress and I stated that very clearly the first session.

Nothing like being a combative "patient" right from the very beginning. Seems to be my calling.

[Cindi Johnson]

Why on earth do we all just unquestionably accept that we all need therapy??? I was born with blue eyes; do I need a therapist to help me cope with blue-eye-ism? I tend to be rather introverted; must I seek a therapist to help me accept the fact that I'm introverted? I was BORN transgendered; do I really need a therapist to convince me to accept -or refute - that I'm transgendered? I was born 63 years ago. And guess what? I've been transgendered for 63 years. I do not need a therapist to help me deal with this FACT.

I have no problem with anyone seeking therapy if they so desire. I do have a problem with being forced to do so. And please, don't equate a therapist with a physician: two different beasts.

You don't need therapy to get breast surgery; you don't need therapy to get your stomach stapled; you don't need therapy to have a nose job; you don't need therapy to be prescribed oxycontin or morphine or viagra or, well, you maybe get the picture. It seems we are being patronized by those who often know little or nothing of transgenderism, yet we don't even object!

It is not written in law that you need therapy to get HRT, even though I suspect many on this website would actually prefer that it were. My physician had no problem writing me a prescription despite the fact that I've never seen a therapist. So,Tess, rather than going to another therapist (and, since you apparently live in Oklahoma, not known for progressive attitudes) and perhaps another and another, until you find one who agrees with you, you might just try to find a doctor willing to prescribe you what you need. Or maybe hop on I-35, point your car south, and in eleven hours or so you'll find a doctor in Nuevo Laredo who'll be a bit more accommodating.

[VanTG]

Well Like you, I have experienced a therapist who did the same thing as what you mentioned. It really made the whole process much more difficult. I felt like I could not talk to her. Fortunately I was able to find a different therapist, who did put me through a psychological battery and I passed with flying colours. Each therapist is different. Are you able to find somebody else?

And What Cindi said is so true

You don't need therapy to get breast surgery; you don't need therapy to get your stomach stapled

I could not state it any better.

[TessaOKC]

Hi Michelle,

According to the "Standard of Care" implemented by the World Professional Association of Transgendered Health, it is "highly suggested" to receive therapy before going on HRT. There are four criteria that should be met and are as follows:

Criteria for Feminizing/Masculinizing Hormone Therapy

1. Persistent, well-documented gender dysphoria;
2. Capacity to make a fully informed decision and to give consent for treatment;
3. Age of majority in a given country (if younger, follow the SOC for children and adolescents);
4. If significant medical or mental concerns are present, they must be reasonably well controlled.

In Oklahoma, three months of therapy is required followed by a letter documenting such. The Standard of Care document is 68 pages long, more like a book.

Hi Kelly,

I made the mistake of telling her that the urges to transition ebbed and flowed in cycles. The desire to transition is always there but at times it is really in my face and at other times it is not. She asked if any of this was sexual with me. I said at times it was and at times it wasn't. She even went on to explain that in bi polar individuals, urges come and go in cycles. I am definately not bi polar so I was a little miffed at that one. They she said that perhaps I had more of a fetish then gender dysphoria. I think after 40 years of feeling this way it's a little more than a fetish. LOL

I am also more of a Tomboy gurl than anything and I agree with you Kelly, I won't turn into a puppet on a string to prove myself to anyone. My therapist seems open to suggestion and I will clarify numerous items with her next week. The last part is, it is the endocrinologist who requests the hrt letter in my state. So, I am a woman trapped in a man's body and that's that. I wanted to be honest in therapy and at least get something out of it. Apparently that may have been the wrong move.....

Hello Cindi,

I just feel we sholdn't have to prove our transgenderism to anyone. I fully understand we need to be informed as to the effects and dangers of hrt, srs, breast augmentation and so on. Some of these therapists are acting like gate keepers and that is blatantly wrong. In calling around to see a therapist, one of them told me I could see them but they would probably not write an hrt letter. What?? Seriously?? The 7th version of the Standard of Care took out specific requirements of therapy probably because too many therapists were acting like traffic cops and keeping trasngendered individuals from moving forward.

Hi Cindy,

Great post and I agree one-hundred percent. It does feel as though we are being treated like transgendered crazy people that need to have our hand held throughout this process. It's already confusing enough!!!

Tess

[Michelle.M]

Why on earth do we all just unquestionably accept that we all need therapy???

Cindi, Tessa knows the answer to that question. See below.


According to the "Standard of Care" implemented by the World Professional Association of Transgendered Health, it is "highly suggested" to receive therapy before going on HRT.

Yeah, I know. But that wasn’t my point. Most of us in transition (or post-transition) did not go to therapy to get an HRT letter. We went to get our transitions on track. HRT is (or maybe is not, depending on the person) simply a part of that. In other words, it’s not the goal, it’s merely a byproduct of the whole process.

This is why I suggested that you ask your therapist why he or she feels you merely have a fetish. If she thinks you’re just shopping around for a letter then she won’t give you one. If you’re for real (and I am not suggesting that you are not), then either the two of you need some more time to explore her concerns or you need to find a therapist with more experience in gender issues.


It is not written in law that you need therapy to get HRT, even though I suspect many on this website would actually prefer that it were.

Please, let’s not be silly. Anyone who wishes to effect a gender transition under the informed consent paradigm is certainly welcome to do so.


Or maybe hop on I-35, point your car south, and in eleven hours or so you'll find a doctor in Nuevo Laredo who'll be a bit more accommodating.

Yup, that’s perfect! Just push on and reconstruct the essential chemistry of your body without the benefit of supervised medical care. Not a particularly bright idea.

[LeaP]

Michelle – great responses. I was going to respond along similar lines, but you have said it all so well!

I'll add my own little, teeny observation here ... And that is that those who need medical intervention the most are usually those who object to gatekeeping the least, because those gates aren't obstacles at all.

[Inna]

Tessa, all in all, you have been presented with an opinion of a therapist after very short time in therapy.
If I had a say in this matter, I would suggest visiting yet another therapist, provided they are Gender specialty, for second opinion.

[Barbara Ella]

Tessa, you are seeing the pattern emerge here from those who have been or are in transition. It is a long process, with ups and downs and stops and gos. Take the advice from your therapist, talk with them and see why it was offered. Think about the discussion and see what fits and what does not, and continue to move forward with all the myriad of things one needs to do to transition. Keep your end goal in mind and don't focus on any one short term item like HRT that may just take more time then desired. Keep moving forward if that is what you feel you want/need.

And if you feel you must have HRT for dysphoria reasons or whatever, do not self medicate. Get in your car, point it to Chicago, and check out the Howard Brown Health Clinic. I go there, have never seen a therapist, and do not feel I need one for the gender issues. Plenty of other reasons for sure, but not that. This is a medical condition that can be treated.

Hugs,

Barbara

[Rachel Smith]

I didn't start therapy with the intent of getting an HRT letter. It was just a by product of learning about myself. I went in with that in mind and after being open an honest with my therapist, the first one, basically telling her my life story I was sent to a GP familiar with GD who recommended me to an endo. Then after seeing one more therapist, due to relocation, that concurred with the first I made an appt with the endo. I never did get a written letter btw.

[TessaOKC]

This is a follow up to last weeks post. I met with my therapist on Wednesday. She once again said that I needed to dress at least part-time in order to receive a hrt letter from her. We went over the "Standard of Care" 7th version and I explained to her that she was not correct in her assessment. I also said that she was acting like a "Gatekeeper" to my hrt and I was not in agreement. She said she didn't want to be a "Gatekeeper" but she felt for my better interest that dressing in front of my supportive wife would be appropriate. I was not happy with her words but after a few days of thinking about it, I came around and have to actually agree.

I have come to realize that my mind and my heart want to desparately transition. My love of my wife and children and in addition, my ego, have prevented me from taking that first step of transition in front of the ones I love. My therapist is looking out for me and I appreciate that. So as soon as my clothing arrives I will begin dressing at night. Sometimes we think we know what is best for us and hate to hear anything different. I was living a dream thinking that transitioning would come with no pain. Please wish me luck, I'm really scared but very excited. What a ride.

[LeaP]

You are correct. There is nothing in any current care standard anywhere that I am aware of that would require this. That does not even your therapist doesn't see the need for you as an individual. From your description of the session, it does not sound as though she is being arbitrary or gatekeeping using some strict standard of reference.

[PaulaQ]

Find a different therapist. Seriously - wtf does some cis person know about what's going on inside you? They don't. Are they a specialist in gender therapy?

I don't know anyone in OKC, but I know someone who's really good in Tulsa, if interested, PM me. (His son is trans, and he gets this stuff.)

Sorry hon, it sounds like you got some gatekeeper who's trying to "protect" you.

You need to prove you are able to give informed consent to treatment, and that's about it.

edit: just saw this part

She said she didn't want to be a "Gatekeeper" but she felt for my better interest that dressing in front of my supportive wife would be appropriate.

Well, maybe that's the case, and look - at some point you are going to have to start presenting as a female in public, so you ought to start someplace, so why not at home? There are lots of us who go on HRT for several months, and get some electrolysis / laser before ever presenting as female. If she drags this out, though, seriously, I'd seek another therapist.

BTW, are you both sure your supportive wife won't freak the hell out when she sees you dressed as a woman?

At some point though, you really are going to have to be willing to be seen, and be out, as yourself. I don't recommend trying to hide the entire process of your physical transition until you feel you look perfect - and then suddenly pop on the scene as a woman. I've seen others try that, and I haven't personally seen it work out very well. A lot of the harder parts of transition are internal, and external in the sense that you have to learn to deal with the world as a woman. So I don't have a problem with her encouraging you to dress as your true self - but holding your HRT letter hostage to that is wrong in my opinion.

[TessaOKC]

Hi Paula,

Thanks for your response, it was wonderful. Her credentials say she is a gender therapist, among other things. She is young. No doubt she is a gate keeper. Aside from that I really like her. She is just way off on the whole hrt letter thing. I will be going armed with the SOC 7th version next week.

I have dressed in front of my wife but it was early on while crossdressing. I do start electrolysis next week and I have been loosing the weight I wanted to so I'll be ready to start hrt in another two months or so. I also agree with you on the being seen in public issue. I will follow her advice and start at home on a regular basis which will be helpful on all fronts. I will ask this coming week just when she plans on writing my hrt letter. If she is any more restrictive then I will be moving on. Thanks again Paula, we are on the same sheet of music, you're great!!!

[angpai30]

I was told the same thing 3 1/2 years ago and I didn't agree with the answer. My stories reflect the same as any other transgender person and to have a person de-validate me like that hurt. I even quit trying to be myself for a little while after. I started transition after realizing that other peoples opinions don't matter unless we make them matter. I later found an OBGYN that prescribes Hormones and she asked me a whole lot of questions and she was astonished I wasn't in transition yet. So, don't let what they said bring you down.

[Frances]

I can't think of much that proves intensity and persistence as a few hundred hours of electrolysis!

Gatekeepers want to evaluate intensity over time, especially if there are red flags. They don't close doors; clients usually exclude themselves from the process. Keep at it and you will get there, if that's what you need to make your life better. You may, however, find out during the process that it isn't.

Forget about theory, diagnoses and standards of care. Explore you inner monologue, history and motivations.

[Michelle.M]

Find a different therapist. Seriously - wtf does some cis person know about what's going on inside you? They don't. Are they a specialist in gender therapy?

Well, that IS the whole point of therapy, is it not? That the client would tell the therapist what's going on inside?



So I don't have a problem with her encouraging you to dress as your true self - but holding your HRT letter hostage to that is wrong in my opinion.

Let's not jump to conclusions. According to SOC V7:

The criteria for hormone therapy are as follows:

1. Persistent, well-documented gender dysphoria;

. . . and this seems to be the whole point to this thread, that the therapist may not be fully aware of what is actually going on in Tessa's interior. That's why I suggested the there might be some more deeply probing questions to find out what, exactly, the therapist's reservations are about Tessa's situation.

If the therapist does not believe that Tessa's condition is either persistent or well-documented, then perhaps this is the topic that should be addressed. "Holding the HRT letter hostage" is probably not an accurate description of what's going on.

[Frances]

We are talking about four sessions. The gender program I went through required eight months of group and individual therapy (two each a month, so every week) before HRT and 2 years before SRS, with one year of living full-time. The only way for the therapist to "see" persistence is to follow the client long enough. Why the need to rush into it? Will Tessa not be trans in six months or so?

I know a few people who wanted it fast. Some excluded themselves from the process before the required timeframes, and did not need to transition after all. Some are now transitioning back into men with gineys because they found another program or therapist that fast-tracked the process. Four sessions is not long enough to change therapists, not by a long shot.

Gatekeeping works, and patience is the name of the game. Hair removal took me about 5 years. Start with that while waiting for the HRT go-ahead.

[Cheyenne Skye]

I'm not going to comment on whether or not the therapist is right or wrong. I will just relate my experience. I was in therapy for slightly more than a year (weekly or bi-weekly sessions depending on scheduling) before hormones even became a topic of conversation. The first time I brought it up, my therapist said we would talk about it at the next session. But that was when things got really bad with my (ex)wife. So hormones actually got tabled for a few months. When it came up again we had a discussion about the Standards of care and informed consent. Once he was sure I knew what the possible outcomes could be if I took hormones, He wrote me "the LETTER". He mailed me a copy and put a note in my file. (I go to a clinic with both therapists and doctors who will prescribe HRT.) So I made my appointment with the doctor. When he saw me I told him why I was there. He checked my chart and said, "OK I'll write the script". That first year or so was mostly about how I could possibly express myself more and still satisfy my wife. (That didn't work :doh:)

Think about using your sessions to discuss the implications of taking hormones. How it will affect your relationships? What happens when the physical changes can no longer be hidden? Stuff like that. So you have options for whatever scenarios you might find yourself in.

[Nicole Erin]

Screw that therapy crap. CIS people don;t know squat about being TG.
You can just as easily get HRT off as website. Not the safest way but just a way to tide you over until this quack breaks.

Also, mention something along the lines of you were hoping to start HRT and how you will need a therapist leading up to SRS. Then say, "cha-ching". Your therapist will start thinking "more moo-lah for me, I better get this girl on some hormones quick."

Well, that is how an Erin would do things.

[Michelle789]

Tessa,

I'm sorry that your therapist doesn't get it. I agree with some of the advice here. You can still start on hair removal, and start growing your hair out. If you're comfortable only, you may start presenting as female on some occasions. You will probably want a wig since your hair isn't grown out yet. Losing weight is a great idea before starting HRT: it will be easier to find women's clothes that fit, and you'll be in better physical shape.

I would listen to Paula and see the recommended therapist in Tulsa. Even though it may be a bit of a drive from OKC, a good gender specialist that gets us is critical. I personally didn't need a therapist to get HRT letter. In California, you don't need a therapist letter and all you need to do is to go see a doctor, but many other states still require a therapist letter. A good therapist will be able to help you with the ins and outs of transition. Consider this a blessing in disguise; your current therapist probably won't be able to help you too much with your transition.

You don't need to go to therapy wearing a dress or heels. I went to my first 8 sessions in male mode, and only started presenting as female when circumstances would allow me too. In my case, there was a drastic change in circumstances in late May/early June of last year so I essentially went full-time; so essentially from the 9th session onward I've been dressing as a female. My therapist told me that she always saw me as a girl, regardless of how I was dressed.

Transition is a long process, with many ups and downs. Please feel free to send me a PM if you need to talk :)

[PaulaQ]

Gatekeeping works, and patience is the name of the game. Hair removal took me about 5 years. Start with that while waiting for the HRT go-ahead.

My first therapist tried this. She really didn't want to give me a letter for HRT - under any circumstances. I'd worked with her for months. By the time I finally begged her to give me the letter I had already found another therapist, and was ready to start over again. Had she refused, I would've had to start over with the new therapist. (I switched to the new therapist anyway - I'd moved out of state by that point.) And to be honest, I probably wouldn't have survived until my new therapist gave me a letter - it took me weeks to get in to see her, plus whatever time she'd have needed to make the determination. I was quite desperate, and hanging on to my life by my finger nails.

That's really the problem with gatekeeping. Some of us are pretty desperate by the time we start this. I know a lot of you may not identify with that, but it was my experience. After about two months on HRT, I felt normal. I'd never felt "normal" before, not once, in my entire life. With HRT, the depression, anxiety, paranoia, and other horrible emotional problems I had just melted away.

BTW, my therapist's objection had nothing to do with gatekeeping - she simply didn't want to take responsibility for my decision, and that a letter shouldn't have been required in the first place. Unfortunately, I was unable to find a doctor who didn't require a letter.

If I hadn't obtained HRT when I did, I'd have almost certainly ended my life - for real, and with finality, and not just attempted it. I was in so much pain.

BTW, my first therapist's initial diagnosis of me was that I was "gender queer." I dunno, take a look at my photos, and see if you think that makes any sense whatsoever.

So I'm sorry, but I think in terms of prescribing medicine, psychotherapists are useful for about one thing only - making sure the patient is not so badly mentally ill that they are unable to give informed consent. (Hint - most of us are sane enough to give informed consent, and it doesn't really take that long to figure this out.) Don't get me wrong - I love my current therapist, and have been seeing her consistently for 15 months now. She's great! I've learned so much about myself, and my gender, working with her. I feel therapy is a very important part of transition.

Should someone be tested psychologically to make sure they'll stick to a diabetic diet - or even made to follow the diet for a while - before being allowed to be treated medically for diabetes? (How many toes should they lose first, if so?)

[Frances]

There are tests for diabetes. All gender therapists have is self-reporting from the client. The client may report persistence, but how can the therapist witness it? If the client has been living in the target gender for a long time, the evaluation time can be shortened. But when confronted with a middle-aged man who invested his masculinity (got married, had children, functionned successfully as a man for over 40 years, etc.), how can the therapist differentiate between "not wanting to a man anymore" and "being a woman?"

I am not an American and do not believe in informed consent access if the client can afford it. The medical care for trans people, in my country, is in part at the expense of tax-payers. It is not to be meted out easily, especially in the absence of tests.

The government recently approved non-gatekeepers, and I am now seeing regretters: people who "knew what they wanted better the therapist." Detransitioning is not cool when you have had SRS.

I also don't buy into the "time is the essence." I know someone who threw away a referal for an endo because the appointment was in 6 months. He tried to get another one with a shorter wait. His therapist was one the newer approved fast-trackers. She had chosen that endo because of the wait; it was a diagnostic tool. The guy told me it had to be "now or never." He never transitioned, as should be.

I know this woman with gender issues who was dating a trans woman. She wanted to start HRT and transition into a man. She started showing up at group meetings and using a male name. She started therapy hoping to jump into HRT. After a few sessions, the therapist detected personnality disorders that were not merely concomitant, but that might have had motivated the desire to transition. The woman never transitioned and is quite happy now. She wanted to be trans to be a part of the community. In her case, HRT would have been irreversible and quite drastic.

If any of my comments on this forum rattle cages, then I am being useful. Transition is not to be taken lightly. On the other hand, if the intensity is strong enough, and the desire to transition has no basis in mental illness and personnality disorders, then my comments should have no impact.

[PaulaQ]

There are tests for diabetes. All gender therapists have is self-reporting from the client. The client may report persistence, but how can the therapist witness it?

So you think psychologists are qualified to diagnose physical medicine? That's what we are talking about here. Why don't they require someone with an MD?


If the client has been living in the target gender for a long time, the evaluation time can be shortened.

We are talking about HRT right? You mean Someone should have been living fulltime as a woman for a while, and that would just shorten the time in therapy? Seriously?


I am not an American and do not believe in informed consent access if the client can afford it. The medical care for trans people, in my country, is in part at the expense of tax-payers. It is not to be meted out easily, especially in the absence of tests.

That type of care isn't available in my country - even people who have private insurance often find that they have no coverage for gender related treatment. I thought about transitioning earlier in my life, but everything I investigated seemed to be designed to block me from obtaining it. Certainly the psychologist I saw as child in the 70's because of my gender had ZERO interest in helping me. Everyone wanted my "problem" to go away. So I tried to make it go away. This required a LOT of alcohol, as it turns out.


The government recently approved non-gatekeepers, and I am now seeing regretters: people who " what they wanted better the therapist." Detransitioning is not cool when you have had SRS.

I was talking about HRT, not SRS, breast augmentation, or FFS. None of the surgeons I'm aware of will perform SRS without a letter from a psychologist and a letter from a psychiatrist or PHd in psychology certifying extensive counseling, and at least one year of life fulltime, and a year on HRT.

I think that is appropriate - people do need to time to be sure this is right for them, and they can do this. I'm not sure why you are conflating gate keeping to start HRT with that for SRS. It used to take one year of living fulltime as a woman while under a psychologist's care here in the US before HRT could be started. Now tell me, in a country where, at the time there was NO protection legally for gender identity nor expression, prejudice was rampant (still is), does that even seem remotely fair? BTW, most places here in the US still offer no such protection.


I also don't buy into the "time is the essence." I know someone who threw away a referal for an endo because the appointment was in 6 months. He tried to get another one with a shorter wait. His therapist was one the newer approved fast-trackers. She had chosen that endo because of the wait; it was a diagnostic tool. The guy told me it had to be "now or never." He never transitioned, as should be.

So you just completely deny what I experienced? Do you think I'm lying about the serious emotional problems I experienced before starting HRT? Do you think I'm lying about going through therapy for several months, only to be told "Oh, I don't write letters!" I'd appreciate an answer on that.

I didn't wait so long to transition because life as a man was awesome. I waited because throughout my life, this just seemed impossible, and every avenue I ever investigated seemed designed to stymie my transition. I needed resources to pay for it, I had to find doctors to help with it (when I was young, information was hard to find). Once I had a kid, I felt obligated to be there for him. And since everyone told me this was just all some psychological issue or fetish, I felt I had no choice but to suppress it.

And so I did, until I reached the breaking point. This is not unheard of in the US, where getting proper medical treatment for gender conditions has historically been difficult, particularly in conservative parts of the country.

So I'm telling you that I didn't have another 6-12 months to await HRT. I feel quite certain I'd have ended my life before that time elapsed. No one was more surprised than I was when 2014 rolled in and I was still here. I'd started HRT in August of 2013, and I got fairly immediate relief from the horrible emotional stuff I was dealing with. I haven't had a panic attack, or been actively depressed or suicidal in well over a year. The anti depressants and anti anxiety meds I was given DID NOTHING. Well, except for Xanax, which calmed me down or knocked me out - but then drinking would've done the same. That was certainly no way I could have lived my life.

So no, the medical establishment here in the US lost its credibility in my eyes when they refused to treat me as a child. They lost their credibility with me when I discovered that even today, I had great difficulty finding doctors who would treat me. Nothing against me, but lots of docs here don't want to treat transsexuals at all.

For example, my niece used to work for one of the best endocrinologists in the city of Dallas. She asked if would consider overseeing my HRT. He told her "no, but he'd be happy to treat me for diabetes, should I need that."

It's nice for you, I hope, that you live in a place where such medical procedures are well supported with public health care. Lots of us don't though, and that changes things significantly.

[Frances]

I actually don't see gatekeeping as a negative, and I think it applies to HRT. Again, remember that it's irreversible for guys. I don't think anyone should be fast-tracked into HRT, unless they have been living as their target gender for a some time. If not, then the therapist needs time to evaluate the intensity, persistence and possibility of concomitant metal illnesses.

I opined on protocols, rules and processes. I was relating stories of people I do know personally, not denying anything about you. Like I said, if you are sure about yourself and your path, none of what I say should matter. I am not a member of WPATH or John Hopkins or whatever.

[TessaOKC]

What a great debate this issue has turned into and I have to admit it really has me thinking!!

To make my point simple I will split transitioning into two categories: First, I think there are those, who without a doubt, have obvious gender dysphoria. They are already dressing, wearing make-up, came out to family and friends, and are very happy and content. Second, like me, there are those of us who are somewhat confused about our gender dysphoria and feel somewhat hesitant at first to consider the big jump of transitioning. The signs and symptoms of gender dysphoria are somewhat mild and the decision to transition might take a lifetime.

I have had gender dysphoria since childhood. I did all the man stuff to try to hide it, former Marine, retired police sergeant, so on and so on. I have to admit that I was initially offended at my therapist blocking the gate to hrt. No one wants to be told what to do, I know I certainly don't. This forum pushed me to think about the situation even further, with all the great responses how could I go wrong..... Many of you are very correct, "What's the hurry??" The excitement of transitioning can be overwhelming and entice one to go forward with great speed. Transitioning is probably the single most significant step one can take in their lives, all encompassing, leaving virtually no part of ones life untouched. Of course we need to be sure of such a step, we'd be fools not to be sure. Right??

So,,,, for girls like me, I need to breath slowly, open my ears and be ready to learn, especially about myself. With each step I become more entrenched and more convinced that transitioning is what's right for me. If I make the list of reasons to transitions vs reasons not to, the "Reasons to transition" list has become increasingly longer. Ahhhh, so I was correct in my self assessment. I was correct that I have been different my whole life. I am correct that I need to transition for me, my sanity and my happiness.